Purging of bone marrow in autologous bone marrow transplantation for non-Hodgkin's lymphoma: a case-matched comparison with unpurged cases by the European Blood and Marrow Transplant Lymphoma Registry.

Abstract

Purging of bone marrow in ABMT for NHL does not affect the rate of hematologic engraftment or risk of procedure-related death (PRD). There is no significant difference in PFS for patients whose bone marrow is purged as compared with unpurged.

Value of autologous stem cell transplantation with purged bone marrow as first-line therapy for follicular lymphoma with high tumor burden: a GOELAMS phase II study

“…No randomized study comparing purged vs unpurged BMT in the treatment of FL has been published to date. The European Marrow and Blood Transplant Registry (EBMTR) 25 has reported that the 5 year OS of patients who received purged (monoclonal antibody or cyclophosphamide) marrow was higher than that of those receiving untreated BM (54% vs 48%) with no difference in PFS (44% in both arms).…”

High-dose therapy with autologous or allogeneic transplantation as salvage therapy for small cleaved cell lymphoma of follicular center cell origin

“…[5][6][7][8]11,12,23 Additionally, the high incidence of bone marrow involvement in SCCL 24,25 limits the effectiveness of autologous transplantation. Accordingly, the use of purged autologous marrow has been advocated 9,26 as has the use of allogeneic marrow. 10,27,28,29 Studies of transplantation in low-grade lymphoma suffer from several methodological problems.…”

“…[1][2][3][4] However, the value of such therapy in patients with low-grade lymphoma is less well established. 5 Issues such as the optimal timing of therapy, [5][6][7] the value of purging, [7][8][9] and the relative merit of autologous stem cells vs allogeneic stem cells 10 remain unresolved. Since some patients with low-grade NHL may experience prolonged survival, even with limited initial therapy such as 'watchful waiting', it is difficult to establish that high-dose therapy has an impact on the survival of patients with low-grade NHL.…”

“…5,7 Resolution of these issues is complicated by the fact that only limited data are available. [5][6][7][8][9][10][11][12][13][14] Additionally, many studies of high-dose therapy and transplantation in low-grade NHL have included cases of mixed cell follicular NHL, 5,11 a disorder which may not be a classical low-grade lymphoma. [15][16][17] To clarify the role of high-dose therapy in conjunction with stem cell transplantation, this report summarizes our results using autologous or allogeneic bone marrow or stem cell transplantation in patients with follicular small cleaved cell lymphoma (SCCL).…”

Transformed lymphoma: an Achilles' heel of non-Hodgkin's lymphoma

“…It remains unclear whether or not purging improves outcomes. [45][46][47][48] Purging may not eliminate t (14;18), but, the significance of its continued presence is unknown. 38,49 Early TRM, ranging from 5 to 20% in the reported series, is most likely reflective of a middle-aged patient group with advanced stage disease, who have been heavily pretreated.…”